The present invention relates generally to the field of dentistry, and more specifically, to a device and method for diagnosis of enamel cavitation in interproximal carious enamel lesions of teeth.
Enamel carious lesions generally involve decalcification of enamel. Early onset lesions contain macroscopically intact enamel without cavitation on the tooth surface and have the potential for remineralization. Advanced enamel lesions contain a broken, that is, a “cavitated” enamel surface that cannot be repaired by remineralization. Treatment of an advanced lesion thus requires tooth preparation and filling by a trained professional.
The integrity of the outer surface of the tooth is essential for the possibility of remineralization. If the outer surface is intact, it protects the etched inner crystals of hydroxyapatite from being coated by salivary proteins and bacterial plaque. A smooth outer surface also allows the tooth to be cleaned with dental floss to remove plaque. In contrast, a cavitated or carious enamel surface is a surface that is pitted and the top enamel coat is missing. A cavitated surface cannot be readily re-calcified (remineralized) and cannot be readily cleaned of plaque with dental floss.
If the potential cavitated lesion is on a readily-accessible tooth surface, direct visualization or direct physical detection with a dental probe is the preferred techniques to identify whether the lesion contains an intact enamel surface. This technique will not work for interproximal lesions, i.e., lesions occurring on surfaces of a tooth that are between teeth. One technique to diagnose and/or treat an enamel cavitation of an interproximal tooth surface has been to place spacers between the teeth in question prior to diagnosis. These spacers separate the teeth in question and allow a dentist to physically probe the interproximal surface with dental instruments. One drawback to implanting spacers is that some patients may refuse to wear them. Another drawback is that after treatment the teeth must move back together, and this takes time. Additional drawbacks to implanting spacers include the time required for the spacing to develop, which can take hours to days, the limited access gained due to the relatively small amount of resulting tooth movement, discomfort associated with spacer placement, and impaction of food into the resulting spaces after removal of the spacers and before the teeth move back into their original positions.
Another technique to detect an interproximal cavitated surface is through X-rays. Although dental X-rays are useful for detecting the presence of interproximal dental lesions, because the lesions themselves cannot be seen clinically, it is difficult to assess the true condition of the enamel surface to accurately prescribe treatment. Therefore, even with X-rays, it is still difficult to assess the condition of the enamel surface.
What is needed therefore is a rapid, noninvasive, painless and inexpensive but accurate means for detecting and diagnosing cavitation of interproximal surfaces between suspect teeth.